Danielle Bailey-Lash does not smoke or drink but was diagnosed with a stage 3 brain tumor at age 35. She worries that the pollution from Duke Energy’s Belews Creeks coal-fired power plant near her home in Stokes County, North Carolina, was behind her illness and the unusual number of cancers in her neighbors — a connection that the state has tried to dismiss with a flawed cancer-cluster study. (Image is a still from this Appalachian Voices video about illnesses near the Belews Creek plant.)The spill of tens of thousands of tons of coal ash into the Dan River from an impoundment at a Duke Energy power plant in North Carolina back in February 2014 triggered a long-overdue public discussion in the state about the dangers of toxic coal plant waste and how it might be better handled.

In response to those concerns, the NC Department of Health and Human Services’ Occupational and Environmental Epidemiology Branch asked the NC Central Cancer Registry to look at cancer rates near coal ash waste sites at power plants. The analysis completed last year says there’s no cause for worry about cancer clusters near those sites.

But an epidemiologist who reviewed the analysis for Facing South said it does nothing of the sort.

“This ‘research’ from the state is a typical smoke screen,” said Steve Wing, a professor in the school of public health at the University of North Carolina at Chapel Hill whose own research has looked at health impacts of industrial livestock operations, leukemia deaths among nuclear weapons facility workers, and cancers in people exposed to radioactive pollution from the 1979 Three Mile Island nuclear power plant disaster in Pennsylvania.

The state’s analysis examined cancer incidence rates in the 14 North Carolina counties with coal ash impoundments. The analysis looked at a variety of cancers: the four most common (lung/bronchus, colorectal, female breast, and prostate), environmental cancers (liver, pancreas, leukemia, brain, bladder, kidney, multiple myeloma, and non-Hodgkin lymphoma), and gastrointestinal cancers (stomach, small intestine, and colorectal).

Comparing county and state numbers, the analysis found significantly elevated rates for lung/bronchus cancer in Gaston, Rockingham and Stokes counties; for prostate cancer in Robeson County; for liver cancer in Gaston County; and for multiple myeloma in Wayne County. It also found some cancers occurring in the 14 counties at rates significantly lower than the state’s.

In those counties where some cancers occurred at elevated rates, the researchers did further analysis by age, since cancers occur most often in older people. At that point, the differences between the counties in question and the rest of the state disappeared, and the cancer registry determined no additional study was necessary.

“To summarize, the additional analysis by age group did not show elevated rates, so no further investigation is indicated,” NCDHHS spokesperson Alexandra Lefebvre told Facing South.

But Wing questions the state’s claim that looking at cancer rates at the county level tells us anything about whether there are cancer clusters near coal ash impoundments.

“Of course the vast majority of people in ‘exposed’ counties are not exposed to coal ash,” he wrote in an email. “Real studies would assess air, water and possibly food pathways, establish who really has an uptake of contaminants, and compare these groups to people who aren’t exposed. That kind of work is expensive and beyond the capacity of the state. So they do these formulaic comparisons and declare no further research is needed.”

Wing called the state’s study “negative by design.” Lefebvre declined to comment on his critique.

Digging Up a Buried Study

The coal ash and cancer analysis is dated Aug. 27, 2015, but it does not appear to have been publicized at the time. Searches of the NCDHHS website turned up no links to the analysis or press releases about it. When Facing South requested a link, Lefebvre sent a PDF instead. People who closely follow coal ash issues in North Carolina say they were not informed of its release.

“Nobody here has any recollection of it,” said Amy Adams, a former regional supervisor for the state environmental agency who now focuses on coal ash issues for the North Carolina office of Appalachian Voices, a nonprofit environmental advocacy group.

Appalachian Voices and Facing South learned about the existence of the study the same way: from a story by freelance reporter Ted Strong published last month by the nonprofit Carolina Public Press (CPP) on health concerns among residents living near Duke’s Asheville plant. Strong wrote:

The North Carolina Central Cancer Registry is the state office charged with investigating potential cancer clusters.

After the Dan River spill, the registry looked into the rates of stomach cancers and gastrointestinal tumors in 14 counties linked to coal ash sites.

On its website, the registry says this: “Real cancer clusters are extremely rare. There have been no proven cancer clusters in North Carolina, and only a few around the United States.”

On an age-adjusted basis, the researchers didn’t find any difference between the counties in question and the rest of the state, “so no further investigation is indicated,” said DHHS spokeswoman Alexandra Lefebvre in an email to CPP.

Facing South contacted Strong to find out how he learned about the study and heard back from CPP Managing Editor Frank Taylor, who attributed the revelation to “good reporting.”

In the course of researching the story, Taylor said, Strong spoke with a state employee who was involved in producing the coal ash and cancer analysis. The employee told Strong — off the record — that the report existed and suggested he request it.

Once Strong had the report in hand, he faced another hurdle: finding an expert willing to discuss the science behind the state’s approach. Strong reported that he reached out to several epidemiological experts who either chose not to respond or said they were unwilling to be quoted on the record. Taylor confirmed that, saying academic sources contacted were willing to speak only on background.

Adams noted that her group has also had difficulty finding experts willing to talk about coal ash-related problems in North Carolina. In the case of Appalachian Voices, they were looking for physicians in coal ash-impacted communities willing to go on the record about what they’ve witnessed in terms of patients’ health.

“Folks will just not come forward,” Adams said.

Power Plants’ Numerous Toxic Threats

The idea that pollution from a coal-fired power plant could affect the health of people living nearby is not far-fetched. What is far-fetched is the idea that living near such a major source of toxic pollution wouldn’t affect people’s health.

In 2014, the most recent year for which data is available, Duke Energy self-reported that its power plants across the state released more than 2.3 million pounds of toxic chemicals to the air, including cancer-causing arsenic, chromium, and lead, according to the Environmental Protection Agency’s Toxics Release Inventory. The company reported dumping another 82,000 pounds of toxic chemicals into surface waters like rivers and lakes, and another 593,000 pounds into its onsite impoundments like the one that failed at the Dan River plant.

The Belews Creek plant alone — Duke’s largest power plant in the Carolinas and among those where nearby residents have complained about unusual patterns of illnesses — released over 600,000 pounds of toxic chemicals to the air in 2014, including 250 pounds of arsenic, 380 pounds of chromium, and 230 pounds of lead. It reported dumping another 132,000 pounds of toxic chemicals into impoundments and almost 19,000 pounds into Belews Lake that year.

Then consider how much pollution the plant has dumped into the environment since it began operating in 1974. Looking just at the decade from from 2005 through 2014, the Belews Creek plant self-reported emitting over 48 million pounds of toxic chemicals to the air, over 135,000 pounds to surface waters, and over 2.2 million pounds to impoundments.

During that decade, the amount of pollution that plant and others emits to the air dropped dramatically after North Carolina’s Clean Smokestacks Act, adopted in 2002, was implemented. For example the Belews Creek plant emitted 15 million pounds of toxic chemicals to the air in 2005 compared to just about 600,000 pounds a decade letter — a 96 percent decrease.

But as more pollutants are caught in smokestack scrubbers, they are being disposed of instead in impoundments and landfills at the power plant sites. Because these existing disposal facilities are unlined, they put potent toxins in contact with groundwater.

Monitoring near the coal ash impoundments at the Belews Creek plant has found levels of heavy metals in groundwater that exceed state standards. For example, chromium was found at levels that exceeds state standards by 50 percent, and most of the chromium in coal ash is of the particularly toxic and cancer-causing hexavalent form.

So is it surprising that people living near these plants report unusual patterns of illness? And are these alleged disease clusters mere happenstance, as North Carolina officials want the public to believe? Adams of Appalachian Voices doesn’t think so.

“The stories are so similar going from community to community,” she said. “The only thing they have in common is proximity to these facilities.”

But rather than making it easier for people living near coal ash dumps and other toxic pollution sources to protect themselves from potential environmental health threats, the North Carolina legislature is considering steps to make it more difficult.

In response to ongoing controversy over health warnings that the state issued to well owners near coal ash dumpsites and later withdrew, legislation was introduced at the General Assembly last month to prevent these warnings from being issued over drinking water contamination except in a very limited number of cases. Environmental health advocates are fighting to stop the bills from becoming law.

“Everyone deserves to know what’s in their water and the potential risks,” said Jeri Cruz-Segarra, a well owner near Duke Energy’s Asheville Steam Station who was warned not to drink her well water last year. “The state has the responsibility to give us clear information.”

Sue is editorial director at the Institute for Southern Studies, which she joined in November 2005 as director of the Institute's Gulf Coast Reconstruction Watch, a project to document and investigate the post-Katrina recovery. A former staff writer for the Raleigh News & Observer and Independent Weekly (Durham, North Carolina), Sue directs and regularly contributes to the Institute's online magazine, Facing South, with a focus on energy and environmental issues. Sue is the author or coauthor of five Institute reports, including "Faith in the Gulf" (August/September 2008), "Hurricane Katrina and the Guiding Principles on Internal Displacement" (January 2008) and "Blueprint for Gulf Renewal" (August/September 2007). Sue holds a Master's degree in journalism from New York University.

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